CHARLES DERRELL WILLIS

COMMERCE, CA
NPI1699259507
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2018-09-18
Last Update Date2018-09-18
Business Address
CHARLES DERRELL WILLIS
5650 JILLSON ST
COMMERCE, CA 90040-1482
Phone number: 323-201-4516
Mailing Address
CHARLES DERRELL WILLIS
1518 N SERRANO AVE
LOS ANGELES, CA 90027-4874
Phone number: 323-536-7817
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